Pharmacology Flashcards
What is the mechanism of action for ASA?
Inactivates cyclooxygenase (COX) enzyme which decreases the production of prostaglandins in the tissue, blocking the pain receptors sensitivity and decreases inflammation. Due to the inactivation of COX, thromboxane A2 production is also inhibited, which is responsible for platelet aggregation
What are the indications for ASA?
Acute coronary syndrome
What are the contraindications of ASA? (3)
GI bleed
Asthmatics sensitive to ASA
Hypersensitivity
What is the dosage of ASA
160-325mg PO (chewed)
What are the side effects of ASA? (5)
Indigestion Gastric bleeding Urticaria Anaphylaxis Nausea/vomiting
What are the precautions of ASA?
Patients on other platelet inhibitors
What is the classification of epinephrine? (2)
Sympathomimetic
Adrenergic
What is the mechanism of action of epinephrine? (7)
Stimulates alpha and beta receptors
Increases heart rate
Increases AV conduction
Increases force of myocardial contractility
Increases vasoconstriction (increases SVR)
Relaxes bronchial smooth muscle
Increases coronary and cerebral blood flow
What are the indications of epinephrine?
Anaphylaxis
What are the contraindications of epinephrine?
No contraindications
What is the adult dosage of epinephrine? (2)
- 3-0.5mg SQ/IM 1:1000 q 5-20 min
0. 1mg IV 1:10000
What is the pediatric dosage of epinephrine?
0.01mg/kg IM/SQ max 0.3 mg
What are the side effects of epinephrine? (7)
Anxiety Headache HTN Cardiac dysrhythmias Tremors Chest pain Nausea/vomiting
What are the precautions of epinephrine? (4)
Cardiovascular disease
Elderly patients
Hypertension
Pregnancy
What is the classification of glucagon?
Pancreatic hormone
What is the mechanism of action of glucagon? (2)
Stimulates the release of glycogen from the liver for glycogenolysis
Smooth muscle relaxation
What are the indications of glucagon? (3)
Hypoglycemia
Beta blocker overdose
Esophageal foreign body
What are the contraindications of glucagon? (2)
Hypersensitivity
Pheochromocytoma
What is the adult dosage of glucagon for hypoglycemia?
1mg IM/SQ/IV
What is the pediatric dosage of glucagon for hypoglycemia?
0.5mg IM/IV/SQ (
What is the adult dosage of glucagon for a beta blocker overdose?
2-5mg IV
What is the pediatric dosage of glucagon for a beta blocker overdose?
0.5mg IM/IV/SQ (
What is the adult dosage of glucagon for an esophageal foreign body?
1mg IM/IV
What is the pediatric dosage of glucagon for esophageal foreign body?
0.5mg IM/IV/SQ (
What are the side effects of glucagon? (4)
Nausea/vomiting
Rebound hyperglycemia
Hypotension
Tachycardia
What are the precautions of glucagon? (2)
Effective only if there are sufficient stores of glycogen within the liver
Use with caution in patients with cardiovascular or renal disease
What is the classification of oral glucose?
Sugar
What is the mechanism of action of oral glucose? (2)
Provides glucose content for regular cell metabolism
Usually absorbed through mucus membranes
What are the indications of oral glucose?
BGL
What are the contraindications of oral glucose? (2)
Unable to maintain their own airway
Altered LOC
What is the dose of oral glucose?
1 tube orally/buccal PRN
What are the side effects of oral glucose?
None
What are the precautions of oral glucose?
None
What is the classification of nitroglycerin? (3)
Anti-angina
Vascular smooth muscle relaxer
Vasodilator
What is the mechanism of action of nitroglycerin? (2)
Relaxes vascular smooth muscle, there by dilating the veins and arterioles, causing blood pooling, which reduces preload
Reduces left ventricular systolic wall tension, which decreases afterload
What are the indications of nitroglycerin? (2)
Possible ischemia due to: unstable angina or AMI
Pulmonary edema
What are the contraindications of nitroglycerin? (6)
Hypotension Severe bradycardia Severe tachycardia Increase in ICP Increase intracranial hemorrhage Patients that have taken ED medications
What is the dose of nitroglycerin (2)
0.4mg SL q 5 min
Infusion: 5.0 mcg/min titrate to effect increasing 5.0-10.0 mcg/min q 5-10 min
What are the side effects of nitroglycerin? (8)
Headaches Hypotension Bradycardia Postural syncope Weakness Dizziness Nausea/vomiting Reflex tachycardia
What are the precautions of nitroglycerin?
Administration to right ventricular infarct patients can result in severe hypotension
What is the classification of salbutamol? (2)
Bronchodilator
Sympathomimetic B-2 agonist
What is the mechanism of action of salbutamol?
Selective B-2 stimulation allows for smooth muscle relaxation of the bronchioles. Also has some B-1 affects causing an increase in HR
What are the indications of salbutamol?
Bronchoconstriction
What are the contraindications of salbutamol? (2)
Relative ischemic chest pain
Hypersensitivity
What are the side effects of salbutamol? (5)
Hypertension Tachycardia Muscle cramps Dry nose and throat Headache
What are the precautions of salbutamol?
Pts with cardiac origin pulmonary edema
What is the adult dose of salbutamol? (2)
5.0 mg NEB
4-6 puffs via MDI (1 puff q 30 sec)
What is the pediatric dose of salbutamol? (2)
2.5mg NEB
2-3 puffs MDI (1 puff q 30 sec)
What is the infant dose of salbutamol? (1)
1.25 mg NEB
What is the classification of tetracaine?
Topical anesthetic
What is the mechanism of action of tetracaine?
Topical ophthalmic anesthetic to allow for flushing of an eye by removing the blink reflex
What is the indication of tetracaine?
To facilitate eye flushing
What is the contraindications of tetracaine? (2)
Hypersensitivity to local anesthetics (caine family)
Possible penetrating eye injury
What is the dose of tetracaine? (2)
2-3 drops in affected eye
Once treatment is done, moist gauze should be placed over eye until blink reflex returns
What are the side effects of tetracaine?
May briefly increase irritation
What are the precautions of tetracaine?
May cause blurred vision
What is the classification of diphenhydramine? (2)
Antihistamine
Anticholinergic
What is the mechanism of action of diphenhydramine? (4)
Competes with free histamines for biding and blocks H1 histamine receptors
Antagonizes the effects of histamine on Histamine (HA) receptors, leading to a reduction of the negative symptoms brought on by histamine
CNS depressant
Has antiemetic properties
What is the indication of diphenhydramine?
Allergic and anaphylactic reactions involving respiratory difficulties, edema or severe itching
What are the contraindications of diphenhydramine?
Hypersensitivity
What are the side effects of diphenhydramine? (8)
Drowsiness Dizziness Headaches Excitable state Thickening of bronchial secretions Chest tightness Reflex tachycardia Hypotension
What are the precautions of diphenhydramine? (2)
The sedative effects of diphenhydramine can be potentiated by the administration of CNS depressants, other antihistamines, narcotics and alcohol
Acute asthma as it may thicken secretions
What is the adult dose of diphenhydramine?
25-50 mg IV/IM/IO
What is the pediatric dose of diphenhydramine?
1-2mg/kg IV/IM/IO (max 50 mg)
What is the classification of calcium chloride?
Electrolyte
What is the mechanism of action of calcium chloride? (3)
Essential component for functional integrity of nervous and muscular system
Enhances automaticity
Positive inotrope
What is the classification of magnesium sulfate? (4)
Electrolyte
Anticonvulsant (toxemia)
Antiarrhythmic (TDP, TCA OD)
Uterine relaxant
What is the mechanism of action of magnesium sulfate? (3)
Reduces striated muscle contractions, causing vasodilation
Blocks peripheral neuromuscular transmission by reducing Ach released at the end-plate by motor nerve impulses
Minimizes recurrences of seizures in the toxic state
What is the classification of potassium chloride?
Electrolyte
What is the mechanism of action of potassium chloride?
Principle intracellular ion affecting muscular contraction and nervous system transmission
What is the classification of sodium bicarbonate? (2)
Alkalinizing agent
Electrolyte
What is the mechanism of action of sodium bicarbonate?
Reacts with H+ ions to form water and CO2
What is the mechanism of action of pentaspan? (5)
Polysaccharides with water retaining properties and intravascular retention
The colloidal properties make it a useful volume expander
Intravascular infusion of pentaspan results in expansion of plasma in excess of the volume of pentaspan infused
Expansion exists for approx 18-24 hrs and is expected to improve hemodynamic status for 12-18 hours
70% of drug eliminated in 24 hours
What is the classification of voluven?
Plasma volume expander
What is the mechanism of action of voluven? (2)
Colloidal properties makes it a useful volume expander
Isovolemic exchange of blood maintains volume for at least 6 hours
What is the classification of ASA? (3)
Antiplatelet
NSAID
Antipyretic
